WHO releases global guidance for HBV, HCV elimination
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WHO released the first-ever global guidance for countries seeking validated hepatitis B virus and hepatitis C virus elimination.
“The 2016 WHO Global Health Sector Strategy (GHSS) on viral hepatitis provided a roadmap for the elimination of viral hepatitis as a public health problem by 2030,” Philippa Easterbrook, MD, global hepatitis and HIV department for WHO, and colleagues wrote. “The 2020 Sustainable Development Goals and GHSS target of reducing the incidence of hepatitis B has been met. However, most other global 2020 targets have been missed, and accelerated action is needed to reach elimination.”
Interim guidance outlines the framework for elimination, ensuring countries are motivated and able to continue in their progress regardless of epidemic profiles, baseline levels of endemicity and affected populations, all while using existing evaluation strategies. Although WHO encourages countries to pursue elimination of HBV and HCV simultaneously, they may choose to apply separately for one of four certifications: elimination of mother-to-child transmission of HBV (option A), elimination of HCV as a public health problem (option B), elimination of HBV as a public health problem (option C) or elimination of HBV and HCV together as a public health problem (option D).
Researchers noted the target for elimination of mother-to-child HBV is a hepatitis B surface antigen prevalence of 0.1% or lower in children aged 5 years or younger, the HCV reduction target is an annual HCV incidence of five or fewer cases per 100,000 adults and the HBV/HCV mortality reduction targets are an annual HBV-related mortality rate of four or fewer deaths per 100,000 individuals and HCV-related mortality rate of two or fewer deaths per 100,000 individuals.
“This guidance is intended to motivate countries to take rapid and appropriate action toward viral hepatitis elimination. It is also important that the validation process is country-led and driven,” Meg Doherty, director of WHO’s global HIV, hepatitis and sexually transmitted infections programs, said in a press release. “There are important differences across countries in their hepatitis B and C epidemics, and they will need to adapt the process and national targets to their context and affected populations.”
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Easterbrook P, et al. Lancet Gastroenterol Hepatol. 2021;doi:10.1016/S2468-1253(21)00267-3.
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